Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)

OBJECTIVES: Most thyroid diseases are nodular and have been investigated using ultrasound-guided fine needle aspiration biopsy (FNAB), the reports of which are standardized by the Bethesda System. Bethesda category III represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The objective of the present study was to evaluate the differences in the malignancy rates among Bethesda III subcategories. METHODS: Data from 1,479 patients who had thyroid surgery were reviewed. In total, 1,093 patients (89.6% female, mean age 52.7 (13-89) years) were included, and 386 patients were excluded. FNAB results (based on Bethesda Class) and histopathological results (benign or malignant) for coincident areas were collected. Bethesda III patients were subcategorized according to cytopathological characteristics (FLUS: follicular lesion of undetermined significance, Bethesda IIIA; AUS: atypia of undetermined significance, Bethesda IIIB). Data were correlated to obtain the malignancy rates for each Bethesda category and the newly defined subcategory. RESULTS: FNAB results for these patients were as follows: Bethesda I: 3.1%; Bethesda II: 18.6%; Bethesda III: 35.0%; Bethesda IV: 22.1%; Bethesda V: 4.1%; and Bethesda VI: 17.1%. The malignancy rates for Bethesda Class IIIB were significantly higher than those for Bethesda Class IIIA (p<0.001) and Bethesda Class IV (p<0.001). Bethesda Class IIIA showed significantly lower malignancy rates than Bethesda Class III overall (p<0.001) CONCLUSIONS: Improvements of the Bethesda System should consider this subcategorization to better reflect different malignancy rates, which may have a significant impact on the decision-making process.

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Main Authors: Mosca,Leticia, Silva,Luiz Fernando Ferraz da, Carneiro,Paulo Campos, Chacon,Danielle Azevedo, Araujo-Neto,Vergilius Jose Furtado de, Araujo-Filho,Vergilius Jose Furtado de, Cernea,Claudio Roberto
Format: Digital revista
Language:English
Published: Faculdade de Medicina / USP 2018
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322018000100229
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spelling oai:scielo:S1807-593220180001002292018-05-25Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)Mosca,LeticiaSilva,Luiz Fernando Ferraz daCarneiro,Paulo CamposChacon,Danielle AzevedoAraujo-Neto,Vergilius Jose Furtado deAraujo-Filho,Vergilius Jose Furtado deCernea,Claudio Roberto Thyroid Ultrasound Fine Needle Aspiration Biopsy Bethesda OBJECTIVES: Most thyroid diseases are nodular and have been investigated using ultrasound-guided fine needle aspiration biopsy (FNAB), the reports of which are standardized by the Bethesda System. Bethesda category III represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The objective of the present study was to evaluate the differences in the malignancy rates among Bethesda III subcategories. METHODS: Data from 1,479 patients who had thyroid surgery were reviewed. In total, 1,093 patients (89.6% female, mean age 52.7 (13-89) years) were included, and 386 patients were excluded. FNAB results (based on Bethesda Class) and histopathological results (benign or malignant) for coincident areas were collected. Bethesda III patients were subcategorized according to cytopathological characteristics (FLUS: follicular lesion of undetermined significance, Bethesda IIIA; AUS: atypia of undetermined significance, Bethesda IIIB). Data were correlated to obtain the malignancy rates for each Bethesda category and the newly defined subcategory. RESULTS: FNAB results for these patients were as follows: Bethesda I: 3.1%; Bethesda II: 18.6%; Bethesda III: 35.0%; Bethesda IV: 22.1%; Bethesda V: 4.1%; and Bethesda VI: 17.1%. The malignancy rates for Bethesda Class IIIB were significantly higher than those for Bethesda Class IIIA (p<0.001) and Bethesda Class IV (p<0.001). Bethesda Class IIIA showed significantly lower malignancy rates than Bethesda Class III overall (p<0.001) CONCLUSIONS: Improvements of the Bethesda System should consider this subcategorization to better reflect different malignancy rates, which may have a significant impact on the decision-making process.info:eu-repo/semantics/openAccessFaculdade de Medicina / USPClinics v.73 20182018-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322018000100229en10.6061/clinics/2018/e370
institution SCIELO
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databasecode rev-scielo-br
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region America del Sur
libraryname SciELO
language English
format Digital
author Mosca,Leticia
Silva,Luiz Fernando Ferraz da
Carneiro,Paulo Campos
Chacon,Danielle Azevedo
Araujo-Neto,Vergilius Jose Furtado de
Araujo-Filho,Vergilius Jose Furtado de
Cernea,Claudio Roberto
spellingShingle Mosca,Leticia
Silva,Luiz Fernando Ferraz da
Carneiro,Paulo Campos
Chacon,Danielle Azevedo
Araujo-Neto,Vergilius Jose Furtado de
Araujo-Filho,Vergilius Jose Furtado de
Cernea,Claudio Roberto
Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
author_facet Mosca,Leticia
Silva,Luiz Fernando Ferraz da
Carneiro,Paulo Campos
Chacon,Danielle Azevedo
Araujo-Neto,Vergilius Jose Furtado de
Araujo-Filho,Vergilius Jose Furtado de
Cernea,Claudio Roberto
author_sort Mosca,Leticia
title Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
title_short Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
title_full Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
title_fullStr Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
title_full_unstemmed Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
title_sort malignancy rates for bethesda iii subcategories in thyroid fine needle aspiration biopsy (fnab)
description OBJECTIVES: Most thyroid diseases are nodular and have been investigated using ultrasound-guided fine needle aspiration biopsy (FNAB), the reports of which are standardized by the Bethesda System. Bethesda category III represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The objective of the present study was to evaluate the differences in the malignancy rates among Bethesda III subcategories. METHODS: Data from 1,479 patients who had thyroid surgery were reviewed. In total, 1,093 patients (89.6% female, mean age 52.7 (13-89) years) were included, and 386 patients were excluded. FNAB results (based on Bethesda Class) and histopathological results (benign or malignant) for coincident areas were collected. Bethesda III patients were subcategorized according to cytopathological characteristics (FLUS: follicular lesion of undetermined significance, Bethesda IIIA; AUS: atypia of undetermined significance, Bethesda IIIB). Data were correlated to obtain the malignancy rates for each Bethesda category and the newly defined subcategory. RESULTS: FNAB results for these patients were as follows: Bethesda I: 3.1%; Bethesda II: 18.6%; Bethesda III: 35.0%; Bethesda IV: 22.1%; Bethesda V: 4.1%; and Bethesda VI: 17.1%. The malignancy rates for Bethesda Class IIIB were significantly higher than those for Bethesda Class IIIA (p<0.001) and Bethesda Class IV (p<0.001). Bethesda Class IIIA showed significantly lower malignancy rates than Bethesda Class III overall (p<0.001) CONCLUSIONS: Improvements of the Bethesda System should consider this subcategorization to better reflect different malignancy rates, which may have a significant impact on the decision-making process.
publisher Faculdade de Medicina / USP
publishDate 2018
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322018000100229
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